Shared Flashcard Set

Details

Dermatology 3B - Lectures 1 and 2
N/A
88
Medical
Undergraduate 4
04/08/2015

Additional Medical Flashcards

 


 

Cards

Term
Crust
Definition
dried exudate
Term
scale
Definition
visible and palpable flakes
Term
excoriation
Definition
secondary, superficial ulceration due to scratching
Term
horny
Definition
projection of keratin
Term
lichenification
Definition
thickening of skin (flat topped) secondary to scratching
Term
maceration
Definition
constant wetting and appearance of surface softening
Term
macule
Definition
flat localised area of colour change, hypopigmented, pigmented or erythematous eg freckle
Term
patch
Definition
a very large macule >10mm eg port wine stains, vitiligo
Term
papule
Definition

Elevated solid lesion, <5mm in diameter

Shape: umbilicated/pedunculated/dome or flat top.

Colour: violaceous/pearly white/yellow/red/blue black. Arrangement: follicular/perifollicular/nil, surface: smooth/vegetations/papillomatous 

eg skin tag, lichen planus, basal cell carcinoma, nevi

Term
nodule
Definition
Larger papule, >5mm may be fluid filled or solid, can be deeper
Term
plaque
Definition
Plateau like elevated lesion, may be a collection of papules, >10mm diameter, less than 5mm high eg plantar wart
Term
vesicle
Definition
papule with clear fluid, <5mm in diameter.  Flaccid, tense, umbilicated. Base: normal, erythmeatous, urticated. Contents: clear, turbid, blood tinged. Secondary: erosions, crusts.
Term
bulla
Definition
Larger version of a vesicle >5mm. Flaccid, tense, umbilicated. Base: normal, erythmeatous, urticated. Contents: clear, turbid, blood tinged. Secondary: erosions, crusts.
Term
pustule
Definition
papule containing pus, eg acne
Term
cyst
Definition
Nodule containing fluid or semi solid material, subdermal eg sebaceous cyst
Term
wheal
Definition
Transitory elevated lesions, plaque or papule, erythematous and odematous. May have central clearing. Are sharp, well defined with irregular borders. eg hives, insect bite
Term

secondary lesions examples

Definition
scales, crusts, erosion, ulcer, excoriation, lichenification, atrophy, scar, fissure
Term
special lesion examples
Definition
petechiae (rbcs in dermis <5mm), purpura (rbcs in dermis >5mm), telangectasia, burrows, comedomes
Term
Difference between purpura and erythema when blanching skin?
Definition
purpura do not blanch, erythema does
Term
Where does haemosiderin mostly occur, and major cause?
Definition
Ankles, underlying venous disorder
Term
Difference between vasculitis and telangiectasia?
Definition
Vasculitis is transient inflammation of vessels eg chilblains and RP, telangiectasis is permanently dilated capillaries and venules
Term
Major factors to consider when examining lesions
Definition
size, distribution, arrangement, colour, secondary changes, primary lesion
Term
[image]
Definition
Erythema - sign of inflammation and infection or systemic disorder like SLE
Term
3 Layers of the skin
Definition
Epidermis, dermis, hypodermis
Term
Epidermis contains
Definition
25-30 layers of dead cells, helps to regulate body temperature. Has 5 layers, (Stratum C, L, G, S B)
Term
Dermis role:
Definition
cushions body from stress and strain, harbours nerves, follicles, glands, vessels
Term
Role of hypodermis:
Definition
attaches skin to bone and muscle, contains fat
Term
Roles of skin:
Definition

- protection

-immune surveillance

-sensation

-thermoregulation

-control fo evaporation

-storage and synthesis

- absoroption

- water resistance

Term
Three types of skin areas and the bacteria that thrive:
Definition

Sebaceous: propionibacteria and staph

Moist: corynebacteria, staph

Dry: proteobacteria, flavobacteriales

Term
What are 4 different sources that determine skin colour?
Definition

melanin: brown

carotene: yellow to orange

haemoglobin: purple

oxyhemoglobin: red

Term
How many skin types are there and which one burns but doesnt tan?
Definition
six, type 1
Term

[image]

name the type of lesion

Definition
papule
Term

[image]

name the type of lesion

Definition
plaque
Term

[image]

name the type of lesion

Definition
cyst
Term

[image]

name the type of distribution

Definition
polycyclic distribution
Term

[image]

Name the type of lesion

Definition
wheal
Term

[image]

name the distribution

Definition
annular
Term

[image]

name the distribution

Definition
arcuate
Term

[image]

name the distribution

Definition

nummmular/discoid

 

Term

[image]

name the distribution

Definition
retiform
Term
Characteristic signs of eczema?
Definition
pruritis, erythema, macule/papule/vesicle/plaque
Term
Main features acute dermatitis?
Definition
erythema, odema, vesicles, weeping, pruritus +++
Term
Main features subacute dermatitis?
Definition
erythema, scaling, papules, vesicles, pruritus ++
Term
Main features chronic dermatitis?
Definition
erythema, scaling, lichenification, pruritus +
Term

What is this condition and what is the most critical feature of it?

[image]

Definition
Exfoliative dermatitis, affects 90% of body. Patient quite unwell, is losing fluids and proteins. Cant maintain body temp
Term
What is the hygiene hypothesis>
Definition
A reduction in the frequency of childhood infections results in an increase of various allergic and autoimmune diseases
Term
Diagnostic criteria for atopic dermatitis? (3/4 needed)
Definition

- pruritus


-morphology and distribution of lesions for age

-chronicity

-personal or family history of astham, allergic rhinitis or atopic dermatitis

Term
At least 50% of people with atopic dermatitis have a defect in what?
Definition
filaggrin, which usually maintains barrier in stratum corneum
Term
At what age do 60% experience their first outbreak of atopic dermatitis?
Definition
One, but may present at any age
Term
What are the distributions of Atopic dermatitis through the four phases of life?
Definition

Infant: cheeks, face, scalp, trunk, extensor surfaces.

Child - wrists, ankles, back of thighs, popliteal fossa. 

Young adult: face, neck, arms, back, flexures. 

Adult: hands, neck and face

Term
Management of atopic dermatitis
Definition

-Reduce triggers

- regular emollients life long

-topical steroids initially intensive then intermittent

-topical calcineurin inhibitors

-oral antibiotics

-oral antihistamines

-phototherapy

-immunosuppression if long term

Term
Features of seborrheic dermatitis
Definition
Scaly, flaky, red, itchy rash of scalp, face and trunk affecting any age
Term
Organism associated with seborrheic dermatitis
Definition
Malassezia, a yeast
Term
Factors associated with seborrheic dermatitis?
Definition
parkinsons, facial palsy, polio, HIV, stress
Term
[image]
Definition
Seborrheic dermatitis
Term
Management of seborrheic dermatitis
Definition

- controlled with regular antifungal and intermittent topical steroids (hydrocortisone twice daily for 1-2wks)

- infantile type usually clears itself

-medicated shampoos with ketoconazole, zinc pyrithione, coal tar, salicyclic acid etc twice weekly for a month or more

-topical calcineurin inhibitors eg pimecrolimus or tacrolimus

-severe may need oral antifungal or UV

 

Term
Pompholyx dyshidrotic eczema main features
Definition
- crops of deep seated, clear vesicles on palms and sides of fingers, can involve sole and cause nail dystrophy.
Term
What can flare pompholyx eczema
Definition

-stress

-hot weather

-hx of atopic dermatitis

-tinea pedis sometimes

-nickel allergy

Term
[image]
Definition
Pompholyx dyshidrotic eczema
Term
[image]
Definition
stasis dermatitis
Term
Management of stasis dermatitis
Definition

-dry up ooze with potassium permanganate/dilute vinegar/gauze as compresses

-oral antibiotics eg flucloxacillin for secondary infection

-topical corticosteroid beginning with most potent for a few days to milder until resolved

-coal tar ointment

- do not scratch

-protect skin from injury

-address vascular issues refer for imaging or compression stockings

Term
Features and causes of asteatotic eczema (eczema craquele)
Definition
excessive dryness of skin, occurs in older ages esp on legs. Causes are environmental (weather and soaps), tends to affect those on drugs (retinoids, diueretics), or with underlying thryoid, malnutrition or weight loss issues.
Term
[image]
Definition
Asteatotic eczema (eczema craquele)
Term
Features of nummular/discoid eczema
Definition
round or oval, blistered or dry skin lesions. Are itchy, chronic, relapsing and common on legs
Term
[image]
Definition
Nummular/discoid eczema
Term
Cause and features of lichen simplex
Definition
Due to repeated rubbing and scratching of a primary itch from a number of conditions (including neurological), causes localised plaque of chronic eczema. Occurs wrist, ankle, anogenitcal, back of neck.
Term
[image]
Definition
Lichen simplex
Term
Contact dermatits causes and features
Definition

-irrtating substance or allergen, difficult to distinguish may coexist

- large burning, itching rash that can take days to weeks to heal

Term
[image]
Definition
Contact dermatitis
Term
Diagnosis and management of contact dermatitis
Definition

Diagnose with patch test and history taking

avoid allergens/irritants, use protectice equipment, emollients and thick moisturisers without fragrance on active rash, topical steroids, topical/oral antibiotics, oral steroid for short course for severe, phototherapy, immunosuppresion eg (tacrolimus, cyclosporin, calcineurin inhibitors), topical 

 

Term
Perioral dermatitis main lesion type, where it affects and who it affects?
Definition
Red papules, around mouth, eventually nose or eyes. Women 20-45
Term
Main cause, exacerbating factors and treatment of perioral dermatitis
Definition

- topical glucocorticosteroids, oily face/cosmetics or fluoride toothpaste. Exacerbated by cosmetics, soaps

Treatment by topical erythromycin or in severe cases oral forms of tetracycline antibiotics

Term
[image]
Definition
Perioral dermatitis
Term
General management principles of dermatitis
Definition
-protect skin, emollients, topical steroids unless perioral, oral/topical antibitiocs to treat/avoid local infection, oral antihistamines to prevent itching, systemic steroid/immunosuppressive if severe
Term
What is the structure of the stratum corneum compared to?
Definition
Brick and mortar
Term
Difference between orthokeratosis, parakeratosis, dyskeratosis
Definition

Orthokeratosis: thickening of keratin (norm0

Parakeratosis: accelerated keratin activity secondary to inflamm, cells dont have time to shed nuclei

Dyskeratosis: imperfect keratinocyte activity, stratum spinosum undergoes premature abnormal keratinisation

Term
Normal skin turnover time
Definition
28 days
Term
Papulo-squamous disorder is? Examples?
Definition
Presents with both papules and scales, or both scaly papules and plaques eg psoriasis/ Lichen Planus
Term
Psoriasis presentation and features
Definition

- chronic, symmetrical, erythematous, scaling plaques/papules.

- chronic, recurrent, immune mediated

Term
Chronic plaque psoriasis features and location
Definition

- red, sharply defined scaling papulers that coalesce to form stable round oval plaques. Scale is silvery white, adherent and point bleeds on removal (ausoltz sign).

- Appears on extensor extremities, scalp, sacrum, nails, ears, gluteal cleft 

Term
[image]
Definition
Chronic plaque psoriasis
Term
Appearance of guttate psoriasis and who it affects, plus any associations
Definition
Numerous, monomorphic scaly papules that suddenly appear on trunk. Affects mainly children and young adults. Can be associated with strep and viral infections.
Term
[image]
Definition
Guttate psoriasis
Term
Pustular Psoriasis; forms, associations, features
Definition

Localised (chronic), generalised (medical emergency)

Associated with tobacco use

Small sterile pustules from red tender base on palms and soles, do not ruputre but turn dark brown and scale.

Term
[image]
Definition
Pustular psoriasis
Term
Erythrodermic psoriasis; bodily features and associations
Definition

Total body redness with chills or high body temp, skin pain. May be drug related or bought on infection/streoid withdrawal/irritant topicals.

Is medical emergency

Term
[image]
Definition
Nail psoriasis
Term
Management of psoriasis
Definition

Soap free substitutes, thick moisturisers

1st Topical - steroids, tar, calcipotriene (vit d analogue)

2nd Physical - phototherapy

3rd Systemic - retinoids, methotrexate, cyclosporin, biologics

Supporting users have an ad free experience!